Empire Blue Cross Blue Shield Drug & Alcohol Rehab Coverage

Does Empire Blue Cross Blue Shield Cover Rehab?

Empire Blue Cross Blue Shield does provide some coverage for drug and alcohol treatment, including rehabilitation for substance abuse issues. The amount that your insurance will cover for rehab, however, depends on your specific Empire BCBS plan and various other factors. In fact, the cost of addiction treatment varies widely and will depend on your specific plan, your provider, your medical and psychological needs, and more.

In addition to providing coverage for addiction treatment, Empire BCBS offers a care management program for substance use disorder (SUD).¹ The program is aimed to help members with addiction better understand and manage their SUD. Empire Blue Cross Blue Shield will provide support and help you create a care plan that fits your needs and lifestyle.

Verify Empire BCBS Insurance Coverage

If you have Blue Cross Blue Shield Insurance Coverage, you can easily verify your benefits with our admissions navigators below. Simply fill out the form, and an admissions navigator will contact you shortly with a comprehensive breakdown of your plan, your coverage, and your treatment options.

Is Substance Abuse Treatment Covered by Insurance?

Under the Affordable Care Act (ACA), insurance providers—including Empire Blue Cross Blue Shield—are required to provide coverage for mental health care and treatment. This includes treatments for substance use disorder and co-occurring mental health disorders, as this is an essential service that must be accessible to all who need it.⁸

What Addiction Treatment Does Empire BCBS Cover?

If you have Empire Blue Cross Blue Shield, there are a range of drug and alcohol rehab programs that may be covered depending on your plan:

• Detoxification – As your body rids itself of harmful substances, a medical detox ensures the process is safe and potentially dangerous side effects are managed.
• Inpatient or Residential Treatment – Inpatient or residential treatment centers are live-in addiction facilities, designed for the individual who needs to leave their environment and focus solely on their recovery.
• Outpatient Rehab Treatment  – Outpatient facilities offer treatment programs during the day, and allow the individual to return home in the evening. These programs are more appropriate for those who must maintain certain responsibilities (work, school, family, etc.) while undergoing treatment.
• Medication Assisted Treatment (MAT) – A comprehensive approach to treatment, MAT uses certain medications and behavioral therapies to help individuals in the recovery process.
• Group and Individual Therapy – Group therapy is when a group of individuals are treated at the same time by at least one therapist. On the other hand, individual therapy treatment is when a single individual receives counseling from at least one therapist to help them overcome their addiction.

Does Empire BCBS Insurance Cover Mental Health?

Thanks to the ACA, mental health treatment must be covered by insurance providers.⁸ The extent to which mental health treatment is covered depends on the particular plan you have. If you are an Empire BCBS member and need to access mental health care, you can take comfort in the knowledge that the company is fully committed to caring for members with mental health conditions. The National Alliance Health Purchaser Group named Empire’s behavioral health value-based payment program an industry leader among healthcare plans. This includes their coverage and support for substance use disorder (SUD), behavioral health outpatient care, and medical/behavioral health integration.⁹

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What is Empire Blue Cross Blue Shield Insurance?

Empire BCBS is the largest health insurance provider in New York State, serving over 4 million members in 28 counties in the eastern and southeastern parts of the state.^2,3, In October 2015, HealthPlus Amerigroup and Empire BlueCross BlueShield merged and became Empire BlueCross BlueShield HealthPlus. The merger created a more streamlined experience for members, regulators, and healthcare providers offering care to New York state residents.⁴

The Blue Cross Blue Shield Association is a federation of 35 independent and locally run health insurance companies that provide coverage to millions of Americans across the country.⁵ Empire Blue Cross Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association that serves members in New York State.⁵

Sources

1. Empire BCBS. (2021). Substance Use Disorder.
2. Blue Cross Blue Shield. (2015, February 3). Empire BlueCross BlueShield Welcomes The Hospital For Special Surgery To Its Exchange Network.
3. (n.d.). Empire BlueCross BlueShield.
4. Empire BCBS. (2015, September 30). HealthPlus Amerigroup to be Rebranded as Empire BlueCross BlueShield HealthPlus in October.
5. Blue Cross Blue Shield. (2021). BCBS Companies and Licensees.
6. Empire BCBS. (2021). Health Insurance Plans in New York.
7. Anthem BCBS. (2021). How to Choose a Health Insurance Plan.
8. gov. (n.d.). Mental Health and Substance Abuse Coverage.
9. Empire BCBS. (2021). Behavioral Health Provider Collaboration.